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General NPI Number Information
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NPI Number | 1265429856
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Entity Type | Organization
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Legal Business Name | CARILLON NURSING AND REHABILITATION CENTER LLC
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 830 PARK AVE
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City | HUNTINGTON
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State | NY
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Zip | 11743-4543
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Country | US
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Telephone | 631-271-5800
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Fax | 631-271-5806
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Provider Business Mailing Address
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Address Line | 830 PARK AVE
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City | HUNTINGTON
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State | NY
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Zip | 11743-4543
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Country | US
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Telephone | 631-271-5800
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Fax | 631-271-5806
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOSEPH F CARILLO II
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Credential |
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Telephone | 631-271-5800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 5153306N
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License Number State | NY
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